Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-03-14
- Last updated
- 2020-01-23
Licenses
- License MI
- 4301045669
Location
- Practice location
- 1049 E NEWELL ST
- City
- WHITE CLOUD MI
- Postal code
- 493498795
- Phone
- 231-689-7330
Organization contact
- Name
- CAROL MILLS
- Title
- Executive Director
- Phone
- 2316897330
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.